Brownwood Life Care Center, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

366 Issued in AR

Legal business name

BROWNWOOD LIFE CARE CENTER, INC.

Practice address

2121 Towson Ave
Fort Smith, AR 72901-5904

Phone

(479) 785-2273

Fax

(479) 785-0583

NPI assigned

Mar 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kimberly Nadine Prybuto

Title

Business Manager

Phone

(479) 785-2273

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendall Darren Wagner, M.D.

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1699091264
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548386600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015904",
            "telephone_number": "479-785-2273",
            "fax_number": "479-785-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 TOWSON AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729015904",
            "telephone_number": "479-785-2273",
            "fax_number": "479-785-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWNWOOD LIFE CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRYBUTO",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "NADINE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "479-785-2273",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "AR",
            "license": "366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kessia Brown, MHPP
• Richard Norman Brown, MD
• Tyler Brown
• Wayne Brown Jr., QBHP
• Zackery Donald Brown, DO
• Audrae Dawn Bruce, APRN
• Karen Elizabeth Bruce, OTR
• Cameron Chancey Bruso, CRNA
• Kayla Grace Bruso
• James Lewis Bruton, MD

• Intellectual Disabilities Intermediate Care Facility in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Intellectual Disabilities Intermediate Care Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.